A Lesson In Free Universal Healthcare

This was posted a few months ago but news of recent times has made it more pertinent.

America beware. Under the stewardship of President Obama, it has been suggested that this may be a route that needs pursuing - free universal healthcare. In Britain, we have the National Health Service (NHS), which was established over 60 years ago in 1948. Before this people were generally forced to pay for their healthcare, although free treatment was available from some teaching and charity hospitals. It was common to pay money into friendly societies that operated insurance schemes and from 1911 onwards, National Insurance contributions paid by employees and employers led covered treatment but not medications, in some ways this is comparable to the NHS now refusing to pay for the most expensive of drugs purely on a cost basis. Furthermore, prescription charges must be paid even if the medicine costs less without a prescription.

Time to crunch some numbers. The NHS employs 1.3 million staff. You probably now have the image of doctors and nurses running around in white coats, but you are sadly mistaken. These are mostly middle managers and administrators. The NHS is the 3rd biggest employer in the entire world. Shockingly, Britain is ranked 55th in the world when it comes to number of people per doctor, with 2.2 per 1000 - even Mongolia has more! It costs the tax payer on average £2000 per year to run the NHS. This is a staggering sum of money. Great, you say, this should comprehensively take care of me. Try getting an NHS dentist; due to the lack of willingness to upgrade equipment and improve working conditions, you have got more chance of witnessing an apology from Gordon Brown for his economic mismanagement than you do of finding an NHS dentist. Since 1997 the current regime has increased NHS spending by 80%. This is massive injection of cash, yet has it honestly gone to the right places? There are now less General Practitioner working hours than before this regime, largely due to the fact they were given a major pay rise (this is not a criticism in any way of GP's, I feel they are underpaid for performing a difficult job) however, due to the large hours they were forced to work they naturally can keep the same money and go part time and have a better lifestyle. This is an inherent problem with socialist principles; simply throwing money at a problem in an uncontrolled manner does not make it go away. If you visit an NHS hospital and compare it to a private hospital the differences are staggering. The private hospital will have private en-suite rooms with three decent (well, maybe not Gordon Ramsay-esque) meals a day. The main difference is the cleanliness. By going into an NHS hospital for a minor procedure you run the risk of catching a super bug, such as MRSA. Even then you have been lucky to have made it that far. The waiting lists for minor procedures are massive. Only if you are seriously ill will NHS treat you quickly. A recent visit to an accident and emergency room showed firsthand how the service is clogged up by dealing with drunkards who are on first name terms with staff that treat everybody with contempt as they are solely concerned with shifting numbers, leading to poor, impersonal service. It was obvious that there was a lack of hygiene at the hospital, and it was surprising to see so many uniformed staff just stood around doing nothing. Strangely the staff was keen for you to choose your ethnicity from a list. Does this really have any bearing on your treatment?

You may think, “Private medical insurance must cost the earth if the service is infinitely better.” You will be pleased and surprised to know that is not the case. For an average person, £1000 a year will get you the top level of cover. This is arguably essential as your health is your most important asset. It is fair to categorise the NHS not as a healthcare system, it never has cared for you when you are in good health, but rather a fairer term would be 'illness care', as that is the time it actually kicks into effect. Even then you may not have access to the latest cutting edge drugs that private cover could get you as they are regarded as too expensive. With the increased funding provided by the Labour regime it is interesting to note that according to a BBC report in March 2008, the average waiting time for treatment on the NHS had risen from 41 days in 1997-1998 to 49 days in 2007, once again proof that a huge injection of cash in the system has not improved matters.

The problems seem to be more deep rooted than simply a lack of funds; it seems there is a complete lack of structure. I believe that the true purpose of the NHS at government level may now be simply to provide even more public sector jobs, which have now swollen to such an incomprehensible size that it would be nearly impossible to streamline in one swoop due to the large increase in unemployment. But is this seriously a good reason to stick with a second rate health system? A better alternative would be to take the control completely out of the incompetent hands of the government and to have compulsory medical insurance either provided by the employer, with a tax break as an incentive, or paid for by the employee, tax free, unlike the present system, whereby you have to pay tax on this cover because you are helping the government by removing a burden – how generous of them! The Institute of Employment Studies in 2001 stated, “The majority of companies are spending between 2% and 16% of their annual budget on sickness absence alone. Private Medical Insurance will probably only cost around 1% of payroll and could save the employer thousands of pounds of down time.” Robertson Cooper Ltd, in conjunction with 87 major companies, in 2001 found, “The full impact of absence costs UK private sector employers about £1,550 per employee per year - or around 9% of their annual payroll.” For those genuinely unable to work as well as the retired the government should pay the cost of the private cover as this would work out more cost effective, while providing much better facilities, equipment and services than are on offer at present. The more people who have the private cover, the cheaper it will become (think of it as bulk buying). It would be necessary to regulate the profit margins allowed by the provider, or maybe better still, to make sure there is genuine competition in order to keep prices low and quality high, which is the inverse of the current system. Who knows, with these savings, maybe the spare money could be used to shorten the 23 years predicted to dig Britain out of its masses of debt or even to provide the workforce with a tax reduction?

America, if you need a lesson in how not to provide universal healthcare, then the NHS is your role model. President Obama is probably aware that free, universal healthcare in America is unlikely to ever be introduced. America is a country where the government is small and thankfully trusts the individual; it is unlikely that the people would trust government to run such an organisation.